Antipsüh

Antipsüh, short for antipsychotics, are a class of medications used to treat psychosis and certain mood disorders. They are divided into typical (first-generation) and atypical (second-generation) agents. Most antipsüh act by blocking dopamine D2 receptors in the brain, which reduces positive symptoms such as delusions and hallucinations. Atypical antipsüh also antagonize serotonin receptors (notably 5-HT2A), which can help with mood and cognitive symptoms and are associated with a different side effect profile.

Common indications include schizophrenia and schizoaffective disorder; bipolar disorder with manic or mixed features; treatment‑resistant depression; irritability in autism; and delirium in some medical settings. Effectiveness is greatest for positive symptoms; negative symptoms and cognitive deficits respond variably.

Side effects vary by agent. Extrapyramidal symptoms (parkinsonism, dystonia, akathisia) and tardive dyskinesia can occur, especially with typical agents. Metabolic effects—weight gain, dyslipidemia, and glucose intolerance—are more common with many atypicals. Other effects include sedation, anticholinergic symptoms, orthostatic hypotension, and, with some drugs, QT prolongation. Prolactin elevation can cause galactorrhea or menstrual disturbances. Clozapine is effective for treatment‑resistant schizophrenia but requires regular blood monitoring due to the risk of agranulocytosis.

Monitoring should include weight, glucose and lipid levels, blood pressure, movement disorders, and for clozapine, regular blood counts. Dosing typically starts low and is titrated to effect over several weeks. Discontinuation should be gradual to minimize relapse risk and withdrawal effects.